Association between Systemic Diseases and Endodontic Outcome: A Systematic Review

Aminoshariae, Anita; Kulild, James C.; Mickel, Andre; Fouad, Ashraf F.

doi:10.1016/j.joen.2016.11.008

Cited by 65 publications

(75 citation statements)

References 34 publications

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“…This deficiency was also pointed out in recent systematic reviews of the association of systemic diseases with endodontic outcome (Aminoshariae et al . , Cabanillas‐Balsera et al . ).…”

Section: Discussionmentioning

confidence: 99%

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Impact of systemic diseases and tooth‐based factors on outcome of root canal treatment

2019

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Aim To investigate the impact of systemic health and tooth‐based factors on the outcome of root canal treatment (RCT). Methodology The target population consisted of all patients receiving RCT at the Helsinki University Clinic in 2008–2011. The inclusion criteria were diagnosable pre‐ and postoperative (minimum 6 months after root filling) radiographs and adequate patient records of RCT available. Teeth extracted for nonendodontic reasons were excluded. Patient documents including digital radiographs of 640 permanent teeth in 504 patients were scrutinized. The radiographs were assessed by two examiners under standardized conditions. The Periapical Index was used to define radiographically ‘healthy’ and ‘healing’ cases as successful. Data included systemic health, technical quality of root fillings, type of restoration and level of alveolar bone loss. Statistical evaluation of differences between groups included chi‐squared tests and Fisher's exact tests. Logistic regression modelling utilizing robust standard errors to allow for clustering within patients was applied to analyse factors related to the outcome of RCT. Results The mean age of patients was 51.5 years (standard deviation (SD) 15.0; range 10–83), and 49% were female. In 41 cases (6%), the patient had diabetes mellitus (DM), in 132 (21%) cardiovascular disease and in 284 (44%) no systemic disease. The follow‐up period was 6–71 months (mean 22.7). In the primary analyses, the success rate of RCT was 73.2% in DM patients and 85.6% in patients with no systemic disease (P = 0.043); other systemic diseases had no impact on success. In the multifactorial analysis, the impact of DM became nonsignificant and RCTs were more likely to succeed in the absence of apical periodontitis (AP; odds ratio (OR) = 4.4; P < 0.001), in teeth with optimal root filling quality (OR = 2.5; P < 0.001), in teeth restored with indirect restorations (OR = 3.7; P = 0.002) and in teeth with none/mild alveolar bone loss (OR = 2.4; P = 0.003). Conclusions DM diminished the success of RCT, especially in teeth with apical periodontitis. However, tooth‐based factors had a more profound impact on the outcome of RCT. This should be considered in clinical decision‐making and in assessment of RCT prognosis.

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“…This deficiency was also pointed out in recent systematic reviews of the association of systemic diseases with endodontic outcome (Aminoshariae et al . , Cabanillas‐Balsera et al . ).…”

Section: Discussionmentioning

confidence: 99%

“…) and the outcome of RCT poorer (Aminoshariae et al . ) in DM patients. However, the evidence remains inconclusive.…”

Section: Introductionmentioning

confidence: 92%

Impact of systemic diseases and tooth‐based factors on outcome of root canal treatment

2019

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“…) did not address the aim of the current umbrella review. Finally, four systematic reviews were included (Segura‐Egea et al , Aminoshariae et al , Tibúrcio‐Machado et al . , Cabanillas‐Balsera et al ).…”

Section: Resultsmentioning

confidence: 99%

“…Amongst the four reviews, only two conducted a meta‐analysis (Segura‐Egea et al , Cabanillas‐Balsera et al ). Two reviews (Segura‐Egea et al , Cabanillas‐Balsera et al ) used the Centre for Evidence‐Based Medicine guidelines to assess the quality of included studies, whereas one review (Aminoshariae et al ) used a specific quality assessment scale, based on three domains (selection bias, detection bias and reporting bias). The systematic review by Tibúrcio‐Machado et al .…”

Section: Resultsmentioning

confidence: 99%

“…These reviews have analysed epidemiological studies comparing the prevalence of periapical lesions in root filled teeth and the retention of root filled teeth in diabetic and nondiabetic subjects (Segura‐Egea et al ). Aminoshariae et al () reported there was no overall effect of diabetes on outcomes, but there was evidence for the association of diabetes with worse longitudinal outcomes in cases with preoperative lesions. Tibúrcio‐Machado et al .…”

Section: Introductionmentioning

confidence: 99%

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Association between diabetes and the outcome of root canal treatment in adults: an umbrella review

et al. 2019

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Background Diabetes mellitus is the most common metabolic disorder amongst dental patients. The association between the diabetes and the outcome of root canal treatment is unclear. Aim To conduct an umbrella review to determine whether there is an association between diabetes and the outcome of root canal treatment. Data source The protocol of the review was developed and registered in the PROSPERO database (CRD42019141684). Four electronic databases (PubMed, EBSCHOhost, Cochrane and Scopus databases) were used to perform a literature search until July 2019. Study eligibility criteria, participants and interventions Systematic reviews with or without meta‐analyses published in English assessing any outcomes of root canal treatment comparing diabetic and nondiabetic patients were included. Two reviewers were involved independently in study selection, data extraction and appraising the reviews that were included. Disagreements were resolved with the help of a third reviewer. Study appraisal and synthesis methods The quality of the reviews was assessed using the AMSTAR tool (A measurement tool to assess systematic reviews), with 11 items. Each AMSTAR item was given a score of 1 if the criterion was met, or 0 if the criterion was not met or the information was unclear. Results Four systematic reviews were included. The AMSTAR score for the reviews ranged from 5 to 7, out of a maximum score of 11, and all the systematic reviews were classified as ‘medium’ quality. Limitations Only two systematic reviews included a meta‐analysis. Only systematic reviews published in English were included. Conclusions and implications of key findings Diabetes mellitus is associated with the outcome of root canal treatment and can be considered as a preoperative prognostic factor.

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Epidemiology, Treatment Outcome, and Risk Factors for Apical Periodontitis

Kirkevang¹,

Væth²

2019

Essential Endodontology

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Association between Systemic Diseases and Endodontic Outcome: A Systematic Review

Cited by 65 publications

References 34 publications

Impact of systemic diseases and tooth‐based factors on outcome of root canal treatment

Impact of systemic diseases and tooth‐based factors on outcome of root canal treatment

Association between diabetes and the outcome of root canal treatment in adults: an umbrella review

Epidemiology, Treatment Outcome, and Risk Factors for Apical Periodontitis

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